Basic Information
| Provider Information | |||||||||
| NPI: | 1720448582 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE HEADACHE AND PAIN CENTER | ||||||||
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| OtherOrganizationName: | DOCTORS HOSPITAL | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8101 W 135TH ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8101 W 135TH ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662231111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9134913999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2016 | ||||||||
| LastUpdateDate: | 03/07/2016 | ||||||||
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| AuthorizedOfficialLastName: | DAVIS | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL STAFF COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9133873111 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP3300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Pain |
No ID Information.